Provider Demographics
NPI:1457325367
Name:CALHOUN, CRAIG W (MD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:W
Last Name:CALHOUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ORO VALLEY ANESTHESIA PLLC DEPT 9538
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90084-0001
Mailing Address - Country:US
Mailing Address - Phone:520-529-0313
Mailing Address - Fax:520-901-3642
Practice Address - Street 1:12995 N ORACLE RD
Practice Address - Street 2:SUITE 141 BOX 411
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85739-9528
Practice Address - Country:US
Practice Address - Phone:520-529-0313
Practice Address - Fax:520-901-3642
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD24325207L00000X
AZ38092207L00000X
WAMD60621776207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAXPY204593Medicaid
WA8415366Medicaid
OR227004Medicaid
ORP00031053OtherRR MEDICARE
H26703Medicare UPIN
CAXPY204593Medicaid
OR116023Medicare PIN
AZZ121926Medicare PIN